Inspection on 04/10/05 for Mountfield

This inspection was carried out on 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mountfield 09/11/06

Mountfield 07/07/05

Mountfield 17/02/05

Mountfield 08/09/04

Mountfield 09/03/04

Similar services:

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Claremont House

Oak Ridge

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Mountfield Millcroft Norwich Norfolk NR3 3LS Lead Inspector Ann Catterick Announced 4 October 2005 09.30 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mountfield Address Millcroft, Norwich, Norfolk. NR3 3LS. 01603 416201 01603 409621 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Norfolk County Council - Community Care Fiona Harley Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The home can accommodate 39 Service Users who are older people. Date of last inspection 7th July 2005 Brief Description of the Service: Mountfield is a care home providing personal care and accommodation for 39 older people and is owned by Norfolk County Council. Thirty-seven permanent placements and two respite care. The home stands in its own grounds in a residential area in the north of the city and is close to all local amenities. Mountfield is a purpose built local authority home that was first opened in 1975 and refurbished in 1996. The home is a two-storey building that is divided into 6 units. Each unit has its own lounge and separate dining area with kitchenette. There is also a communal lounge on each floor as well as a large conservatory, bar and shop area. There is a shaft lift giving access to the first floor. At the time of the inspection the home was offering a pilot for restaurant style meal times for those who chose to use the service. This has meant that the lounge near the kitchen has, on a temporary basis, been changed into a dining area. All service users have their own bedroom and two of the bedrooms could be shared if service users chose to do so. Several of the bedrooms are rather small. The home has ample bathing and toilet facilities. The gardens offer further communal space in the summer months. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place on Tuesday the 4th of October 2005. The inspectors was able to meet with service users, some family members, staff and management as well as have a tour of the building and inspect some staff files, care plans and other documents. Prior to the inspection the inspector received a pre inspection questionnaire from the manager and several feedback forms from service users and their relatives. All of the feedback received was positive. On the day of inspection there was a happy and relaxed atmosphere in the home with staff presenting as competent and caring, enjoying the job that they were doing. All of those service users spoken to were very positive about the staff and the quality of care they received within the home. What the service does well: The home was used for a pilot scheme to have a restaurant style service within a downstairs communal area. This has proved very successful. Times for breakfast, lunch and tea are flexible and menus with choices are placed on each table. Service users do not need to choose what they want until they sit at the table. This encourages conversation and discussion and has made meal times a much more social time. Service users can sit where they like and are therefore mixing with a wider range of people than they did when eating on separate units. The manager has also noticed other signs of improved well being that she attributes to this new way of providing meals. If service users choose to eat in their rooms this is fine. All of those service users spoken to were very positive about the new system. One service users comment was, “the food at Mountfield is crème de la crème.” The homes policy and procedures regarding medication were good and ensured best practice. All service users spoke very positively about the staff user phrases such as, “very good to me here,” “staff very kind, bosses excellent.” Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 6 Service users have their needs assessed prior to admission to ensure that these needs can be met and are within the registration of the home. The home does not provide intermediate care. EVIDENCE: Care plans were inspected and evidence of assessments completed by the placing professionals and the manager of the home was seen on file. Service users would not be admitted to the home unless it was felt their needs could be met. All of those service users spoken to felt satisfied with their care and felt their needs were being met. The home has two respite care beds for short-term placements but these are not intermediate care beds. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8 and 9 Care plans were seen and these included all of the information needed to ensure needs are identified and met. Service users individual health needs are met and reviewed on a regular basis. The systems and practice around dealing with medication were inspected and judged to promote safe practice. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 10 EVIDENCE: The care plans of the four most recent service users to be admitted to the home were seen and these were comprehensive and included all of the information required. Care plans are reviewed on a regular basis. Part of the care plan includes aspects of service users health. The home has a good relationship with the local GP practice and the community nurses. Two service users had pressure areas that were being cared for by the district nurses and care staff. Appropriate mattresses and other pressure care equipment were provided. One of these persons was being reassessed as it was felt her needs had changed to nursing need. Nutritional screening was being developed with these being completed for those service users who were most frail and these will eventually be completed for all service users. The home has regular contact with the continence advisor when appropriate. Some service users health needs have deteriorated and these service users have been reassessed and when appropriate have moved to a new placement that more suit their care needs. Alternative ‘well being’ treatments were being looked at and on the day of inspection a qualified therapist was at the home giving hand massage. Those service users who had this treatment seemed to enjoy it very much. A gentleman whose health had deteriorated causing him to be admitted to hospital for some time had returned to the home and was very positive about the care he had received since his health needs had changed. These were included in his care plan. All of service users spoken to seemed to be having their health needs met. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15. Service users seem to be satisfied that the home matches their lifestyle, social and cultural needs. Service users are encouraged to be as independent as possible and take as much control as possible over their own lives. Service users receive a wholesome, varied and balanced diet that is served and prepared at times to suit their needs. The outcome for this standard has been commended. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 12 EVIDENCE: The manager is trying to develop further activities in the home. Bingo, quizzes, movement to music, crafts and reminiscence take place on a regular basis, as well as some individuals following their own hobbies. An example of this is a gentleman who enjoys painting is supported and encouraged in this area. On the day of inspection an aromatherapist was offering hand massage. A Christmas meal was booked at Dunston Hall, a local hotel and leisure centre. Social service act as appointee for three service users. All other service users have their money placed in an account with social services and can access this when they choose. The home holds safe keeping money for service users for items and services such as chiropody, hairdresser or toiletries. This money is held individually and all transactions are recorded with a receipt and are countersigned. The home continues to have the restaurant system for meals and this has been a completed success. For all meals there is a menu with a wide choice and service users choose what they would like at the time they are going to eat it. The manager has noted that since service users have eaten in this way there have been additional benefits relating to socialisation and general well being. If service users choose to eat in their rooms they are able to do this but the overall majority prefer the restaurant style dining room. The inspector felt that this area should be commended. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has a policy and procedures regarding complaints and this is made available to service users and their families. EVIDENCE: There have been no complaints since the last inspection. The details of the complaints procedure are at the entrance to the home and within the Service User Guide. Those service users spoken to said that if they had a complaint they would be happy to discuss this with senior staff. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 26 Service users live in a clean, pleasant and safe well-maintained environment. EVIDENCE: The home is owned by Norfolk County Council and any refurbishment and general maintenance is arranged from central office. The home was refurbished in 1996 and offers a good quality environment for service users to live. A service user who had recently moved into the home was pleased to show the inspector her room and had personalised her room by purchasing her own fixtures and fittings that suited her own lifestyle. Other service users spoken to were satisfied with the accommodation in the home and spoke positively about their environment. The home meets the requirements of the local fire service and has recently purchased fire evacuation chairs to have at the top of each staircase in the home. The home also has special mattress covers on all beds that would assist staff to move service users who were in bed in a safe way, if there were a fire. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28 and 30 The home does not have enough staff employed to cover all sickness and leave and therefore use an unacceptable amount of agency staff to cover shifts. Service users are in safe hands at all times. Staff are trained and competent and on the day of inspection demonstrated that they can fulfil the responsibilities of their posts. Some staff were awaiting the opportunity to complete NVQ level 2 but this was not available to them due to lack of places. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 16 EVIDENCE: The rota offers enough staff on duty at any one time but in the last eight weeks prior to the inspection there were 59 agency staff covering shifts. This is not good practice and Norfolk County Council should aim to address this issue. Staff receive induction and foundation training. The number of staff with NVQ level 2 is disappointing, only 21 . This is far short of the 50 required by this standard. Some staff spoken to were keen to commence their NVQ level 2 but had been informed there were no further places and that they would have to wait some considerable time. It would be helpful when staff were keen to attend training that opportunities were made available, especially when the home does not meet the standard. However the outcome for service users does not appear to be affected by this situation as other training opportunities are good and those staff spoken to on the day of inspection were competent to do their jobs. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33 and 38 The home is managed by a person who is fit, competent and well trained, able to discharge her duties in full. The manager aims to ensure that the home is run in the best interests of the service users. The home offers good practice and sound procedures in the area of health and safety aiming to protect the welfare and safety of service users and staff. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 18 EVIDENCE: The manager has all of the qualification experience and competence she needs to fulfil her role and this is evidenced by feedback from service users and staff as well as in the general quality of care and administration within the home. Quality assurance systems are in place and the manager is recording relevant information. The home has yet to publish its findings and this area will be looked at in more detail at the next inspection. All staff are trained in manual handling, fire safety and first aid. The manager ensures that the COSHH and RIDDOR regulations are followed and aims to follow all other health and safety regulations. Good infection control systems are in place. Since the last inspection the home has further equipment to enable vulnerable adults to be helped out of the building in the safest way possible if there were a fire. Risk assessments have been recorded for individuals and the environment. Those service users spoken to seemed to feel safe and secure living in the home. Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 4 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x 3 x x x x 3 Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 20 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 27 Good Practice Recommendations It would be good practice to ensure that the home has staff in such numbers to enable them to cover most shifts as over 55 agency staff had been used to cover shifts in the eight week period prior to the inspection. It would be good practice if those staff who are keen to complete NVQ do not have to wait significant amountsof time prior to be offered a place on a course. 2. 28 Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 21 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Mountfield I55 s35557 Mountfield v245760 AN 041005(4).doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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